Ranitidine Amoxicillin

Figure 6.3 Plot of the fraction of dose absorbed (in %) of various drugs as a function of the permeability estimates in the Caco-2 system. Key 1 D-glucose 2 verapamil 3 piroxicam 4 phenylalanine 5 cyclosporin 6 enalapril 7 cephalexim 8 losartan 9 lisinopril 10 amoxicillin 11 methyldopa 12 naproxen 13 an-tipyrine 14 desipramine 15 propanolol 16 amiloride 17 metoprolol 18 terbu-taline 19 mannitol 20 cimetidine 21 ranitidine 22 enalaprilate 23 atenolol 24 hydrochlorothiazide.

Data from 20 clinical studies in 5000 patients who had taken ranitidine bismuth citrate (200, 400, or 800 mg bd) have been reported (14). The incidence of adverse events was not different from that associated with placebo and was independent of dose. The most common events (>1% of patients) were upper respiratory tract infections, constipation, diarrhea, nausea, vomiting, dizziness, and headache, the last being the only event reported by over 2% of the patients. Adverse events considered by the chnical investigator to be adverse reactions occurred with a similar frequency amongst patients given ranitidine bismuth citrate (8%), ranitidine hydrochloride (6%), and placebo (6%). The incidence of adverse reactions was greater when amoxicillin (11%) or clarithromycin (20%) were co-prescribed. 

Ranitidine 300 mg bd and omeprazole 20 mg bd have been compared as components of triple therapies (combining them with either amoxicillin plus clarithromycin or amoxicillin plus metronidazole) in 320 patients with H. pylori (5). Omeprazole and ranitidine combined with two antibiotics for 1 week were equally effective in eradicating H. pylori. This result questions the role of profound acid suppression in eradication. There was no difference in the reported adverse effects, which included nausea, vomiting, diarrhea, metallic taste, skin rashes, and headache. 

Transporter absorptive effects predominant Examples. Acyclovir, Amiloride -, Amoxicillin Atenolol Atropine, Bidisomide Bisphosphonates Captoprit, Cefazolin Cetirizine Cimetidine Ciprofloxacin, Cloxacillin Dicloxacillin Erythromycin - -, Famotidine Fexofenadine Folinic acid Furosemide, Ganciclovir Hydrochlorothiazide, Lisinopril Metformin Methotrexate, Nadolol Penicillins Pravastatin Ranitidine Tetracycline Trimethoprim Valsartan Zalcitabine... 

Deppermann K-M, Lode H, HofQ en G, Tschink G, Kalz C, Koeppe P. Influence of ranitidine, pirenzepine, and aluminum magnesium hydroxide on the bioavailability of various antibiotics, including amoxicillin, cephalexin, doxycycline and amoxicillin-clavulanic acid. Antmdcrob Agents Chemodier( 9Z9) 33,1901-1907. 

Cimetidine does not adversely affect the bioavailability of ampicillin or co-amoxiclav, but the bioavailability of oral benzylpenicillin may be increased in some subjects. Ranitidine does not affect the pharmacokinetics of amoxicillin, but may possibly reduce the bioavailability of bacampicillin. 

Cimetidine 200 mg, given three times daily the day before and with a single 200-mg dose of co-amoxiclav (amoxicillin with clavulanic acid), had no significant effect on the bioavailability of amoxicillin or clavulanic acid. Another study found that ranitidine (300 mg given the day before and 150 mg given with the antibacterial) had no effect on the pharmacokinetics of a single 1-g dose of amoxicillin. ... 

Simultaneous acetaminophen, amoxicillin, aspirin, caffeine, cimetidine, codeine, diazepam, omeprazole, ranitidine, theophylline Interfering imipramine... 

Riemann JF, Schilling D, Schauweeker P, Wehlen G, Dorlars D, Kohler B, Maier M (1997) Cure with omeprazole plus amoxicillin vs long-term ranitidine therapy in Helicobacter py/on-associated peptic ulcer bleeding. Gastrointest Endosc 46 299-304... 

Eradication therapy is mainly carried out as a one-week triple therapy, i.e. a proton pump inhibitor (PPI) combined with amoxicillin and clarithromycin or metronidazole. Bismuth or Ranitidine bismuth citrate triple therapies are also prescribed, as... 

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